关键词: 伤害指数, 脑电双频指数, 全身麻醉, 结直肠癌, 术后康复

Abstract:

Objective To evaluate the Nociception Index （NOX） combined with Bispectral Index （BIS） monitoring of anesthesia management during laparoscopic radical resection of colorectal cancer. Methods A total of 80 patients， regardless of gender， aged 50 to 80 years old， and ASA grade Ⅰ or Ⅱ， chose to undergo elective laparoscopic colorectal surgery under total intravenous anesthesia. They were randomly divided into two groups： NOX combined with BIS group （Group N） and BIS alone group （Group C）， with 40 cases in each group. Group N maintains an appropriate analgesia depth （NOX value is 30 ~ 50） and sedation depth （BIS value is 40 ~ 60）， and group C maintains an appropriate sedation depth （BIS 40 ~ 60） and is covered with opaque cards Hide NOX and adjust the appropriate analgesia depth based on the experience of the anesthesiologist. The main observational indicator is the intraoperative remifentanil dosage， and the secondary observational indicators include the intraoperative propofol and cisatracurium dosage， vasoactive drug use， anesthesia recovery and extubation time， postoperative NRS pain score and sufen. The dosage of Titanyl， adverse reactions such as agitation in the postoperative recovery period， postoperative nausea and vomiting， dizziness， and intraoperative awareness. Results The amount of remifentanil used during the operation in group N was significantly less than that in group C （P < 0.05）. The time of postoperative recovery and extubation in group N was significantly earlier than that in group C （P < 0.05）. The number of cases of intraoperative use of vasoactive drugs， the incidence of postoperative agitation during recovery， postoperative nausea and vomiting， and dizziness in group N were significantly lower than those in group C （P < 0.05）. There were no significant differences in the amount of propofol and cis-atracurium used during surgery and the incidence of awareness between the two groups （P > 0.05）. The NRS scores of patients in group N were significantly lower than those in group C at 2， 4， 6， and 24 hours after surgery （P < 0.05）， while there was no significant difference in the NRS scores between the two groups at 48 hours after surgery （P > 0.05）. The consumption of sufentanil in group N was significantly lower than that in group C during the first 12 hours and 12 to 24 hours after surgery （P < 0.05）. There was no significant difference in the consumption of sufentanil between the two groups during the second 24 to 48 hours after surgery （P > 0.05）. Conclusion Compared with BIS monitoring alone， the use of NOX combined with BIS monitoring can maintain relatively stable intraoperative hemodynamics， reduce the amount of general anesthesia drugs， accelerate postoperative anesthesia recovery， improve the quality of anesthesia recovery， and reduce acute postoperative pain， which is beneficial to patients postoperative recovery.

Key words: nociception index, bispectral index, general anesthesia, colorectal cancer, postoperative rehabilitation